[Thirty-nine cases of stage 4 pressure ulcers treated by a two-stage method of debridement and skin flap transfer].

From September 2013 to October 2018, 39 patients (28 males and 11 females, aged 21 to 76 years) with stage 4 pressure ulcers were admitted to the General Hospital of Xinjiang Military Command. The area of pressure ulcers ranged from 2 cm×2 cm to 20 cm×12 cm on admission. The two-stage method of debridement and skin flap transfer was exploited to repair the wounds. In the first stage, a thorough debridement was performed (26 cases underwent debridement once, 10 cases twice, and 3 cases for three times). The skin flap transfer surgery was conducted in the second stage after 6 to 12 days (local skin flap for 16 cases, vascularized island flap for 8 cases, fascial flap for 5 cases, gluteus maximus flap for 5 cases, and biceps femoris flap for 5 cases), with flap area of 4 cm×2 cm to 16 cm×10 cm. Some donor sites were closed by direct suture and the other donor sites which can not be sutured were covered by medium-thickness skin graft from the lateral thigh. All the pressure ulcers of 39 cases were healed with no sinus. During follow-up of 6 months to 5 years, no recurrence of pressure ulcer at the surgical site was observed; the flaps achieved soft texture and good appearance. Thus, the two-stage method of debridement and skin flap transfer achieved good long-term curative effect and could be a preferable option for treating stage 4 pressure ulcers.